Ethiopia - Country Progress Report - unaids

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Report on Progress towards Implementation of the UN Declaration of Commitment on HIV/AIDS 2.2 Current Status of the Epidemic 2.2.1 HIV Prevalence Related UNGASS Indicator Indicator# 22 - Reduction in HIV Prevalence Disaggregation Value Source/Year Numerator: Number of respondents aged 15-49 who have been tested for HIV during the last 12 months and who know their results Indicator Value: Percentage of young women and men aged 15-24 who are HIVinfected 15-24-yearold pregnant women Denominator: Number of all respondents aged 15-49 12,215 5.6% HIV Sentinel Surveillance 254 /2005 Note: After consultation with UNAIDS HQ, the prevalence value of the unadjusted ANC surveillance data (15-24-year-old pregnant women) has been used. This is because ANC data is collected more frequently and over a longer period, making it easier to track trends. Official estimates of HIV prevalence in Ethiopia are contained in the June 2007 “Single Point HIV Prevalence Estimate” document. In 2005, two surveys conducted in Ethiopia included estimates of HIV prevalence. One of these was the populationbased Demographic and Health Survey (DHS), which included HIV testing of respondents’ blood. The other was sentinel surveillance of pregnant women attending antenatal clinics (ANC). The two exercises produced national adult HIV prevalence estimates of 1.4% and 3.5% respectively. In general, the data indicate that the epidemic may be less severe, less generalized and more heterogeneous than previously believed. In early 2007, intensive discussions among the implementing entities and the national authorities in Ethiopia adopted both exercises as valid in the unique context of each exercise’s methodological aims, assumptions and limitations. In early 2007, the Federal HIV/AIDS Prevention and Control Office (FHAPCO) convened a task force to reconcile these two estimates with a view of establishing one single point estimate. Source: Ministry of Health/HAPCO, Single Point HIV Prevalence Estimate, June 2007 Figure 4: Map of Ethiopia showing Adult HIV Prevalence by Region (2007) 8
Report on Progress towards Implementation of the UN Declaration of Commitment on HIV/AIDS The task force used intensive methodologies to develop a single point estimate of adult HIV prevalence of 2.1% in 2007. Analysis of the data shows relatively higher prevalence among females (2.6%) than males (1.7%). Also, the adult HIV prevalence in urban areas is much higher (7.7%) than in rural areas (0.9%). The three highest prevalence regions in the country are Gambela (8.3% urban), Addis Ababa (7.5%) and Dire Dawa (4.2%). Other regions with HIV prevalence rates greater than the national estimate (2.1%) are Harari (3.2%), Amhara (2.7%) and Tigray (2.7%). Somali is the region with the lowest HIV prevalence estimate in the country (0.8%). Additional estimates for 2007 include: • There were about 977,394 people in the country living with HIV • There were about 125,528 new infections, or about 344 a day. • There were 71,902 annual deaths (197 per day) due to AIDS, which includes 10,825 children aged 10-14 years. • There were 75,420 HIV-positive pregnancies and 14,148 HIV-positive births in 2007. • The number of PLHIV requiring ART was 258,264, which includes 242,548 adults (24.8% of those 15 years and older living with HIV) and 15,716 children (24.3% of HIV positive children in the age of 0 to 14 years). 9.0 8.0 7.0 HIV Prevalence (%) 6.0 5.0 4.0 3.0 2.0 1.0 0.0 2004 2005 2006 2007 2008 2009 2010 Urban Urban + Rural Rural Year Source: Ministry of Health/HAPCO, Single Point HIV Prevalence Estimate, June 2007 Figure 5: Estimated and Projected HIV Prevalence by Year, Adult Population 15-49, Urban, Rural, and Total Ethiopia 2004-2010 The Ministry of Health and HAPCO have informed partners that the single point estimate exercise’s national and subnational values “are to be used provisionally in all current planning exercises… until further notice”. A new round of ANC sentinel surveillance was launched in late 2007. The surveillance system has significantly improved over time in terms of representativeness and data quality. The number of surveillance sites increased from nine rural and 26 urban sites in 2002 to 44 rural and 38 urban sites in 2005 5 . The 2007 ANC surveillance data was collected from 100 sites. Analysis of the 2007 data was not completed in time for this report. 2.2.2. A Heterogeneous Epidemic 6 The data suggest that in urban Ethiopia the HIV epidemic started in the mid-1980s, expanded rapidly and reached a plateau around the mid-1990s and stabilized afterwards. As shown in Figure 5, the analysis of seven years of data shows that the prevalence of HIV has been exhibiting a more or less stable trend. The data from urban areas indicates a generalized epidemic that is probably stabilizing or even declining in the major urban centers, but may be increasing in the smaller towns. The rural epidemic appears to be relatively widespread but heterogeneous, with most regions having a relatively low prevalence of HIV, but a few demonstrating prevalence rates greater than 5%. There are marked regional variations, although these cannot be fully understood due to lack of data. The epidemic is higher in small towns and market 5 Federal Ministry of Health: “AIDS in Ethiopia, Sixth Report 2006” 6 This sub-section is composed of excerpts from the final draft of “HIV/AIDS in Ethiopia: An Epidemiological Synthesis” (Yemane B, et.al, 2007), Commissioned by HAPCO and the World Bank. The report was completed in November 2007 and was expected to be launched in early 2008. 9
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